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. 2023 Sep;143(9):5507-5514.
doi: 10.1007/s00402-023-04849-3. Epub 2023 Mar 28.

Minimally invasive Chevron Akin (MICA) osteotomy for severe hallux valgus

Gustavo Araujo Nunes  1   2   3 , Kepler Alencar Mendes de Carvalho  4   5 , Gabriel Ferraz Ferreira  6   7 , Miguel Viana Pereira Filho  6   7 , Andre Donato Baptista  5 , Roberto Zambelli  8 , Jordi Vega  9   10
Affiliations

Minimally invasive Chevron Akin (MICA) osteotomy for severe hallux valgus

Gustavo Araujo Nunes et al. Arch Orthop Trauma Surg. 2023 Sep.

Abstract

Introduction: The minimally invasive Chevron Akin (MICA) osteotomy has been widely used to treat hallux valgus (HV). The purpose of this study was to present a case series of patients with severe HV undergoing surgical treatment using the MICA procedure and to evaluate the clinical and radiographic outcomes.

Materials and methods: Retrospective study including 60 consecutive feet (52 patients) undergoing MICA for severe HV. The data were collected pre- and post-operatively at the last follow-up. Patients were clinically evaluated by the visual analog pain scale (VAS) and AOFAS hallux MTP-IP score. Radiographic assessments included measurements of hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal (MT) length, distal metatarsal articular angle (DMAA), and plantar translation of MT head. The complications were recorded during the follow-up.

Results: The mean age was 59.9 years, and the mean follow-up was 20.5 months. The average AOFAS increased from 41.2 to 90.9 points, and the VAS from 8.1 to 1.3 at the last follow-up. The average HVA decreased from 41.2º to 11.6º, the IMA from 17.1º to 6.9º, and the DMAA from 17.9º to 7.8º. The average shortening of the first metatarsal and the plantar translation of the MT head was 5.1 mm and 2.8 mm, respectively. The most observed complication was hardware discomfort, observed in 5 feet (8.3%). There were two cases of recurrence (3.3%).

Conclusion: MICA technique was demonstrated in this series of cases to be an effective procedure for severe HV, with a low rate of recurrence and an acceptable rate of complications.

Level of evidence: IV; case series.

Keywords: Chevron; Hallux valgus; MICA; Minimally invasive surgery; Percutaneous surgery.

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References

    1. Smyth NA, Aiyer AA (2018) Introduction: Why are there so many different surgeries for hallux valgus? Foot Ankle Clin 23(2):171–182 - DOI - PubMed
    1. Siddiqui NA, LaPorta G, Walsh AL et al (2019) Radiographic outcomes of a percutaneous, reproducible distal metatarsal osteotomy for mild and moderate bunions: a multicenter study. J Foot Ankle Surg 58(6):1215–1222 - DOI - PubMed
    1. Nix S, Smith M, Vicenzino B (2010) Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res 3:21 - DOI - PubMed - PMC
    1. Izzo A, Vallefuoco S, Basso MA et al (2022) Role of lateral soft tissue release in percutaneous hallux valgus surgery: a systematic review and meta-analysis of the literature. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-022-04693-x - DOI - PubMed - PMC
    1. Souza Júnior E, Vieira M, Baumfeld T et al (2020) Patient’s perspective on the surgical treatment of hallux valgus. J Foot Ankle 14(1):36–40 - DOI

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